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经皮椎体成形术治疗骨质疏松性椎体骨折的临床管理

Clinical management of osteoporotic vertebral fracture treated with percutaneous vertebroplasty.

作者信息

Capozzi Anna, Scambia Giovanni, Pedicelli Alessandro, Evangelista Maurizio, Sorge Roberto, Lello Stefano

机构信息

Department of Women and Child Health, Catholic University of Sacred Heart, Rome, Italy.

Department of Interventional Radiology, Institute of Radiology, Catholic University of Sacred Heart, Rome, Italy.

出版信息

Clin Cases Miner Bone Metab. 2017 May-Aug;14(2):161-166. doi: 10.11138/ccmbm/2017.14.1.161. Epub 2017 Oct 25.

Abstract

Our study demonstrated percutaneous vertebroplasty (PVP) is an effective procedure to rapidly reduce back pain in patients affected by acute osteoporotic vertebral compression fractures (OVCFs) assessed by MRI. We confirmed in our sample, femoral bone density impacts more deeply than vertebral T-score and/or BMD on bone strenght, as it is less affected by any interferences. We interestingly found the presence of previous osteoporotic fragility fractures and chronic glucocorticoids therapy should especially negatively influence bone health of our patients. On the other hand, even if both FRAX scores for major osteoporotic fractures and for femoral fractures seemed to globally define a population at major risk for fragility fractures, our analysis is retrospectively done. We choose and suggest a multidisciplinary medical management of these patients, considering OP is a multifactorial disease and OVCFs usually produce lots of different important consequences on general health.

摘要

我们的研究表明,经皮椎体成形术(PVP)是一种通过MRI评估可有效快速减轻急性骨质疏松性椎体压缩骨折(OVCF)患者背痛的手术。我们在样本中证实,股骨骨密度对骨强度的影响比椎体T值和/或骨密度更深远,因为它受任何干扰的影响较小。我们有趣地发现,既往骨质疏松性脆性骨折的存在和慢性糖皮质激素治疗尤其会对我们患者的骨骼健康产生负面影响。另一方面,即使主要骨质疏松性骨折和股骨骨折的FRAX评分似乎总体上定义了一个脆性骨折高风险人群,但我们的分析是回顾性的。考虑到骨质疏松症是一种多因素疾病,OVCF通常会对总体健康产生许多不同的重要后果,我们选择并建议对这些患者进行多学科医疗管理。

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